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Muftuoglu O, Karasu HA. Assessment of mandibular bony healing, mandibular condyle and angulus after orthognathic surgery using fractal dimension method. Med Oral Patol Oral Cir Bucal 2024; 29:e620-e625. [PMID: 38615248 PMCID: PMC11365052 DOI: 10.4317/medoral.26587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2024] [Accepted: 03/25/2024] [Indexed: 04/15/2024] Open
Abstract
BACKGROUND This study aims to compare the trabeculation changes in the bone structure observed at the mandibular osteotomy line and the mandibular condyle in patients after single and double-jaw orthognathic surgery. MATERIAL AND METHODS The study included 38 patients (23 female, 15 male) who underwent mandibular surgery with bilateral sagittal split ramus osteotomy technique. The patients were divided into two groups according to their surgical operation: single-jaw (bilateral sagittal split ramus osteotomy) or double-jaw (Le Fort I osteotomy and bilateral sagittal split ramus osteotomy) surgery. Trabecular changes seen in mandibular osteotomy lines, mandibular condyle and mandibular angulus were evaluated on panoramic radiographs of patients (preoperative, postoperative 2nd day, postoperative 3rd month and 12th month) using fractal analysis method. Fractal dimension analysis was calculated by box counting method. RESULTS No statistically significant difference was found between the fractal analysis values in the mandibular condyle and angulus region preoperatively, postoperative 2nd day, postoperative 3rd month and postoperative 12th month in the single jaw group. There was no statistically significant difference between the fractal analysis values in the mandibular condyle and angulus region preoperatively, postoperative 2nd day, postoperative 3rd month and postoperative 12th month in the double jaw group. A significant difference was found in fractal analysis values in osteotomy lines in both groups. The lowest value was found on the 2nd postoperative day and reached the preoperative values in the 3rd and 12th months postoperatively. Fractal analysis values didn't show significant difference between the single, double-jaw groups in all periods. CONCLUSIONS This result suggests that the fractal analysis method can be used to evaluate trabeculation in the bone healing process of the osteotomy lines and indirectly affected areas in the postoperative period after orthognathic surgery.
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Küçükçakır O, Ersan N, Arslan YZ, Cansız E. Evaluation of mandibular condyle position in Class III patients after bimaxillary orthognathic surgery: A cone-beam computed tomography study. Korean J Orthod 2024; 54:247-256. [PMID: 38981647 PMCID: PMC11270145 DOI: 10.4041/kjod23.188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 05/02/2024] [Accepted: 05/19/2024] [Indexed: 07/11/2024] Open
Abstract
Objective This retrospective study evaluated the mandibular condyle position before and after bimaxillary orthognathic surgery performed with the mandibular condyle positioned manually in patients with mandibular prognathism using cone-beam computed tomography. Methods Overall, 88 mandibular condyles from 44 adult patients (20 female and 24 male) diagnosed with mandibular prognathism due to skeletal Class III malocclusion who underwent bilateral sagittal split ramus osteotomy (BSSRO) and Le Fort I performed using the manual condyle positioning method were included. Cone-beam computed tomography images obtained 1-2 weeks before (T0) and approximately 6 months after (T1) surgery were analyzed in three planes using 3D Slicer software. Statistical significance was set at P < 0.05 level. Results Significant inward rotation of the left mandibular condyle and significant outward rotation of the right mandibular condyle were observed in the axial and coronal planes (P < 0.05). The positions of the right and left condyles in the sagittal plane and the distance between the most medial points of the condyles in the coronal plane did not differ significantly (P > 0.05). Conclusions While the change in the sagittal plane can be maintained as before surgery with manual positioning during the BSSRO procedure, significant inward and outward rotation was observed in the axial and coronal planes, respectively, even in the absence of concomitant temporomandibular joint disorder before or after the operation. Further long-term studies are needed to correlate these findings with possible clinical consequences.
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Affiliation(s)
- Osman Küçükçakır
- Department of Oral and Maxillofacial Surgery, Istanbul University, İstanbul, Turkiye
| | - Nilüfer Ersan
- Department of Dentomaxillofacial Radiology, Yeditepe University, İstanbul, Turkiye
| | - Yunus Ziya Arslan
- Department of Robots and Smart Systems, Institute of Science, Turkish-German University, İstanbul, Turkiye
| | - Erol Cansız
- Department of Oral and Maxillofacial Surgery, Istanbul University, İstanbul, Turkiye
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Kim JY, Yong HS, Kim TY, Kim JY, Jeon KJ, Huh JK. Volumetric changes in temporomandibular joint space following trans-oral vertical ramus osteotomy in patients with mandibular prognathism: a one-year follow-up study. Sci Rep 2024; 14:942. [PMID: 38200085 PMCID: PMC10781718 DOI: 10.1038/s41598-023-51050-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/29/2023] [Indexed: 01/12/2024] Open
Abstract
This study measured and analyzed chronological changes in temporomandibular joint space volume by compartment following transoral vertical ramus osteotomy (TOVRO) using reconstructed 3-dimensional (3D) images of patients with mandibular prognathism. It included 70 joints of 35 patients who underwent TOVRO between January 2018 and December 2021. Computed tomography (CT) or cone-beam CT (CBCT) was performed before surgery (T0) and at 3 days (T1), 6 months (T2), and 12 months postoperatively (T3). These scans were then analyzed using 3D software. The volumes of the overall (Vjs), anterior (Vajs), posterior (Vpjs), medial (Vmjs), and lateral (Vljs) joint spaces were calculated at each time point. A linear mixed model and repeated-measures covariance pattern with unstructured covariance were used to evaluate significant changes in joint space volume over time. Vjs significantly increased to 134.54 ± 34.28 mm3 at T3 compared to T0 (p < 0.001). Vpjas and Vljs increased by 130.72 ± 10.07 mm3 and 109.98 ± 7.52 mm3 at T3 compared to T0, respectively (p < 0.001). However, no significant difference was observed between T0 and T2 in Vajs and Vmjs (p = 0.9999). The observed volume increases in Vpjs and Vljs appeared to contribute to the overall Vjs increase.
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Affiliation(s)
- Jae-Young Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-Ro, Gangnam-Gu, Seoul, 06273, Korea
| | - Hae-Seong Yong
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-Ro, Gangnam-Gu, Seoul, 06273, Korea
| | - Tae-Yeong Kim
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-Ro, Gangnam-Gu, Seoul, 06273, Korea
| | - Jun-Young Kim
- Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Kug Jin Jeon
- Department of Oral and Maxillofacial Radiology, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Jong-Ki Huh
- Department of Oral and Maxillofacial Surgery, Gangnam Severance Hospital, Yonsei University College of Dentistry, 211 Eonju-Ro, Gangnam-Gu, Seoul, 06273, Korea.
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Ravelo V, Olate G, de Moraes M, Huentequeo C, Sacco R, Olate S. Condylar Positional Changes in Skeletal Class II and Class III Malocclusions after Bimaxillary Orthognathic Surgery. J Pers Med 2023; 13:1544. [PMID: 38003858 PMCID: PMC10672009 DOI: 10.3390/jpm13111544] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 10/13/2023] [Accepted: 10/18/2023] [Indexed: 11/26/2023] Open
Abstract
Orthognathic surgery is indicated to modify the position of the maxillomandibular structure; changes in the mandibular position after osteotomy can be related to changes in the position of the mandibular condyle in the articular fossa. The aim of this study was to determine changes produced in the mandibular condyle 6 months after orthognathic surgery. A cross-sectional study was conducted that included subjects who had undergone bimaxillary orthognathic surgery to treat dentofacial deformity of Angle class II (group CII) or Angle class III (group CIII). Standardized images were taken using cone-beam computed tomography 21 days before surgery and 6 months after surgery; measurement scales were used to identify the condylar position and its relations with the anterior, superior, and posterior joint spaces. The results were analyzed using the Shapiro-Wilk and Student's t-tests, while considering a value of p < 0.05 as indicating a significant difference. Fifty-two joints from 26 patients, with an average age of 27.9 years (±10.81), were analyzed. All subjects in both group CII and group CIII showed a significant change in the anterior, superior, and posterior joint spaces. However, postoperative changes in the position of the condyle in the articular fossa were not significant in the anteroposterior analysis. We conclude that orthognathic surgery causes changes in the sagittal position of the mandibular condyle in subjects with mandibular retrognathism and prognathism.
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Affiliation(s)
- Víctor Ravelo
- Division of Oral and Maxillofacial Surgery & CEMYQ, Universidad de La Frontera, Temuco 4780000, Chile
- PhD Program in Morphological Sciences, Facultad de Medicina, Universidad de La Frontera, Temuco 4780000, Chile
| | - Gabriela Olate
- Division of Oral and Maxillofacial Surgery & CEMYQ, Universidad de La Frontera, Temuco 4780000, Chile
| | - Marcio de Moraes
- Division of Oral and Maxillofacial Surgery, Piracicaba Dental School, State University of Campinas, Piracicaba 13414-903, SP, Brazil
| | - Claudio Huentequeo
- Division of Oral and Maxillofacial Surgery & CEMYQ, Universidad de La Frontera, Temuco 4780000, Chile
| | - Roberto Sacco
- Division of Dentistry, Oral Surgery Department, School of Medical Sciences, The University of Manchester, Manchester M13 9PL, UK
- Oral Surgery Department, King's College Hospital NHS Trust, London SE5 9RW, UK
| | - Sergio Olate
- Division of Oral and Maxillofacial Surgery & CEMYQ, Universidad de La Frontera, Temuco 4780000, Chile
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Artificial Intelligence Splint in Orthognathic Surgery for Skeletal Class III Malocclusion: Design and Application. J Craniofac Surg 2023; 34:698-703. [PMID: 36728461 DOI: 10.1097/scs.0000000000009162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/30/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Digital splints are indispensable in orthognathic surgery. However, the present design process of splints is time-consuming and has low reproducibility. To solve these problems, an algorithm for artificial intelligent splints has been developed in this study, making the automatic design of splints accessible. METHODS Firstly, the algorithm and program of the artificial intelligence splint were created. Then a total of 54 patients with skeletal class III malocclusion were included in this study from 2018 to 2020. Pre and postoperative radiographic examinations were performed. The cephalometric measurements were recorded and the difference between virtual simulation and postoperative images was measured. The time cost and differences between artificial intelligent splints and digital splints were analyzed through both model surgery and radiographic images. RESULTS The results showed that the efficiency of designing splints is significantly improved. And the mean difference between artificial intelligent splints and digital splints was <0.15 mm in model surgery. Meanwhile, there was no significant difference between the artificial intelligent splints and digital splints in radiological image analysis. CONCLUSIONS In conclusion, compared with digital splints, artificial intelligent splints could save time for preoperative design while ensuring accuracy. The authors believed that it is conducive to the presurgical design of orthognathic surgery.
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Mashkina AA, Chkadua TZ, Ermolin VI, Isaichikova OV, Romanovsky MA. [Three-dimensional assessment of positional changes of the mandibular condyles following orthognathic surgery]. STOMATOLOGIIA 2023; 102:19-27. [PMID: 36800781 DOI: 10.17116/stomat202310201119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
THE AIM THE STUDY This study aims to assess the postoperative condylar displacement after orthognathic surgery using three-dimensional analysis of computed tomography. MATERIAL AND METHODS This retrospective study included 64 condyles from 32 patients with skeletal Class II (Group 1, n=16) and III (Group 2, n=16) deformities. All patients underwent a bimaxillary surgery. The three-dimensional CT images were evaluated to assess condylar displacement. RESULTS The condyle exhibited mainly superior and lateral torque immediately after surgery. Posterior displaced condyles were found in two cases in group 1 (Class II malocclusion). CONCLUSION The present study found the condyle displacement that can be mistaken as posterior displacement of condyle in analysis of sagittal sections of CT scans.
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Affiliation(s)
- A A Mashkina
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - T Z Chkadua
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - V I Ermolin
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | | | - M A Romanovsky
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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Gulcek BN, Ozbilen EO, Biren S. Changes in the condylar head after orthognathic surgery in Class III patients: a retrospective three-dimensional study. Angle Orthod 2022; 93:488611. [PMID: 36409284 PMCID: PMC9933558 DOI: 10.2319/052922-394.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 10/01/2022] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To evaluate the axial and dimensional changes of the condylar head after orthognathic surgery, including Le Fort I and bilateral sagittal split ramus osteotomies, and to assess condylar remodeling through three-dimensional (3D) surface superimposition. MATERIALS AND METHODS Twenty-four patients (15 females, 9 males; mean age: 32.22 ± 6.92 years) with skeletal Class III deformity were included in the study. Cone-beam computed tomography data obtained in the preoperative (T0) and postoperative (T1) periods were examined using Mimics and 3-Matic software. The height, depth, and width of the condylar head and its angular changes were measured. The volumes of the 3D reconstructed models were calculated, and remodeling amounts were evaluated through regional surface superimposition. Statistical significance was set at P < .05. RESULTS Following the surgery, there was a significant decrease in the size of condyles (P < .05). An inward rotation of the condyles was found in the axial plane (T0: 79.60 ± 6.01°, T1: 76.6 ± 6.48°, P < .05). The maximum resorption, maximum apposition, mean remodeling, and mean absolute remodeling were -2.63 ± 1.23 mm, 1.15 ± 0.4 mm, -0.30 ± 0.34 mm, and 0.73 ± 0.43 mm, respectively. No correlation was found between the angular changes and remodeling parameters or linear and volumetric changes of the condylar head (P > .05). CONCLUSIONS Condyles undergo a remodeling process with a resorptive character following orthognathic surgery, without clinically significant effects in the present study.
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Mashkina AA, Chkadua TZ, Ermolin VI, Isaichikova OV, Romanovsky MA. [Condylar displacement following orthognathic surgery]. STOMATOLOGIIA 2022; 101:77-84. [PMID: 36268926 DOI: 10.17116/stomat202210105177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
The overview of the current literature in the research of mandibular condyle displacement after orthognathic surgeries was done. The correct postoperative mandibular condyle position is considered as one of the determinants of the stability of treatment results.
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Affiliation(s)
- A A Mashkina
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - T Z Chkadua
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | - V I Ermolin
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
| | | | - M A Romanovsky
- Central Research Institute of Dentistry and Maxillofacial Surgery, Moscow, Russia
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